Senior Account Executive

MCS Puerto Rico; San Juan (PR); On-site; USD 65,000 - 85,000; Full time

Job summary

MCS Puerto Rico is seeking a Senior Account Executive to represent the company in service procedures and group renewals. The role ensures effective attendance, communication, and resolution of service-related situations for clients, acting as primary liaison between the employer or group and company management.

Responsibilities include renewing groups, addressing issues, visiting clients to support renewals, delivering materials, and preparing performance reports.

Qualifications

• Bachelor’s degree in a related field with at least 3 years in healthcare insurance.
• Associate’s degree with at least 5 years in customer service/account management in healthcare insurance.

Responsibilities

• Collaborates with Finance for renewal of assigned groups and discusses renewal proposals.
• Resolves service issues reported by customers or producers and logs requests.
• Visits customers to address requests and supports renewal efforts.
• Delivers materials to clients and coordinates training and maintenance of systems.
• Prepares reports on experience or data analysis and presents trends.
• Provides benefits orientation to employees and supports HIPAA-related duties.

Skills

Customer service

Account management

Healthcare insurance

Communication

Education

Bachelor's degree in Business Administration/Health Services Administration

Associate’s degree

Job description

GENERAL DESCRIPTION

The Senior Account Executive represents the company in official service procedures and group renewals. Ensures effective attendance, communication, and resolution of various service-related situations as required by the clients. Serves as primary liaison between the employer or group and the management of the company.

Regular Exempt

ESSENTIAL FUNCTIONS

• Collaborates with the Finance department for the renewal of assigned groups. Develops initiatives to discuss renewal proposals with the producer or client. Notifies the Closing/Pre-Implementation area of any agreements made.
• Addresses, follows-up, and resolves service issues reported by customers or producers. Additionally, documents visits, agreements, and customer requests while maintaining a log of these situations.
• Conducts visits to customers to address their requests, ensure service quality standards are met, and contributes to the group’s renewal efforts. Prepares and discusses an individual work plan with each assigned group. Additionally, participates in information booths and meetings with producers and employers as needed, which may include activities scheduled after business hours. Organize interventions with clinical initiatives programs, coordination of benefits, and corporate presentations, among other interventions.
• Coordinates and ensures the delivery of cards, directories, and any other necessary materials directly to the client, producer, or identified dedicated units.
• Prepares and presents reports of experience or data analysis according to frequency and performance guarantees, including recommendations and trends in Puerto Rico or the United States, and according to the established schedule.
• Delivers and explains the administrative handbook and/or materials to new hire groups. Provide benefits orientation to employees (Benefits Presentation), as required.
• Participates in group implementation meetings for coverage or group changes and coordinates the training and maintenance of the company systems platforms, supplies, and equipment.
• Responsible for managing the Designation of Representative document, which is the Health Insurance Portability and Accountability Act (HIPAA).
• Requests to the Legal area for the development of contracts to deliver and discuss with the client, get the client's signature and ensure compliance with the different internal departments.
• Validates the benefits in the system with the client for new groups and/or after the renewal of groups with changes and coordinates the issuance and delivery of Certificates of Coverage as provided by the Insurance Code and the group request for proposal (RFP).
• Serves as skilled in monitoring the operation and processes and ensures that commitments completed in the RFP are fulfilled, and, if not met, escalates the situation with the appropriate departmental management for resolution.
• Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices.
• May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document.

MINIMUM QUALIFICATIONS

Education and Experience: Bachelor's Degree in Business Administration, Public Administration, Health Services Administration, or related fields. At least three (3) years of experience in customer service, account management, or performing similar functions in the Healthcare Insurance Industry is preferred.

OR

Education and Experience: Associate’s Degree. At least five (5) years of experience in customer service, account management, or performing similar functions in the Healthcare Insurance Industry is preferred.

“Proven experience may be replaced by previously established requirements.”

Certifications / Licenses

A Driver's License valid in the Commonwealth of Puerto Rico is required. A valid Life and Disability Insurance Agent License and Health Services License is required. (Unlicensed candidates or those with a provisional license are accepted. If not licensed, candidates must commit to becoming certified by passing the examination provided by the Commissioner of Insurance on their first or second attempt.)

Other

Car in good condition, available to travel to various locations in Puerto Rico.

Languages

Spanish – Advanced (comprehensive, writing and verbal)

English – Advanced (comprehensive, writing and verbal)

“We are an Equal Employment Opportunity Employer and take Affi